Table 5 Correlates of pain and neuropsychiatric symptoms

Ahn 2013³⁶

56577

Not reported

Wandering 9 %

AOR 0.77 (95 % CI: 0.73-0.81) with wandering

10

Subsample without psychotropic medication

AOR 0.72 (95 % CI: 0.63-0.83) with wandering

(Adjusted for cognition, ADL, sociodemographics)

Kunik 2005³⁴

99

Pain mean 2.4 (SD 1.2)

Delusions/hallucinations mean 0.35 (SD 0.48)

r = 0.15 (p > 0.05) with psychosis

8.5

Leong 2007³⁵

225

Pain 44 %, chronic pain 34 %

Anxiety 48 %

SOR 1.8 (95 % CI: 1.0-3.0) with anxiety

8.5

Norton 2010⁴²

161

Not reported

BEHAVE-AD mean 6..4 (SD 29.2)

r = 0.15 (p = 0.08) for pain intensity and emotional behaviour problems

9

RMBPC-NH mean 1.45 (SD 0.64)

r = 0.05 (p = 0.58) for pain intensity and resistiveness to care

Torvik 2010⁵²

106

Current pain in total group 55 %, in cognitive impaired group 52 %

Negative affect index (DQoL) mean 2.0 (SD 0.75), positive affect/humour index (DQoL) mean 3.4 (SD 0.9)

p < 0.01 for current pain and negative affect

6.5

p = 0.11 for current pain and with positive affect/humour

Tosato 2012³

2822

Any pain 19 % (moderate/severe/excruciating pain 13 %)

Behavioural symptoms 37 % Psychiatric symptoms 21 %

AOR = 0.74 (95 % CI: 0.55-1.0) with wandering

11.5

AOR = 1.4 (95 % CI: 1.08-1.8) with resistance to care

AOR 1.5 (95 % CI: 1.07-2.03) with delusions

AOR 1.06 (95 % CI: 0.80-1.41) with verbal abuse

AOR 1.08 (95 % CI: 0.75-1.55) with physical abuse

(Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition)

Volicer 2009³⁷

929

Daily pain 29 %, less than daily pain 19 %

Verbally abusive not easily altered 2 %, physically abusive not easily altered 12 %

r = 0.07 (p = 0.03) for pain frequency and verbal abuse

11

AOR = 0.9 (p = 0.53) with resisting care

AOR = 0.7 (p = 1.2) with verbal abuse

AOR = 0.7 (p = 0.16) with physical abuse

Delusions 8 %

(Both multivariate models among others controlled for resisting care)

Hallucinations 9 %

Zieber 2005³⁸

58

Not reported

Not reported

r = 0.46 (p < 0.01) for DS-DAT scores and resisting care

8

r = 0.42 (p < 0.01) for DS-DAT scores and aberrant vocalization

Pain rating by palliative care nurse consultants:

r = 0.51 (p < 0.01) with resisting care

r = 0.40 (p < 0.01) with aberrant vocalizations

Pain rating by facility nurse:

r = 0.48 (p < 0.01) with resisting care

r = 0.065 (p < 0.63) with aberrant vocalizations

First author

N

Pain: prevalence

Neuropsychiatric symptoms: prevalence

Correlates of pain with unspecified NPS

Quality of study

Black 2006³⁹

123

Pain 63 %

Psychiatric disorders or behaviour problems 85 %, behaviour problems 67 %

SOR 1.9 (95 % CI: 0.7-5.3) with psychiatric/behaviour problems

6.5

SOR 1.2 (95 % CI: 0.5-2.5) with behaviour problems

Brummel-Smith 2002⁴⁰

104 (excluding those unable to self-report pain)

Moderate-severe pain 60 %

≥1 disruptive behaviours (wandering, verbal disruption, physical aggression, regressive behaviour, hallucinations)

SOR 1.8 (95 % CI: 0.8-4.0) with ≥ 1 disruptive behaviour

7

No-mild pain 40 %

50 subject unable to answer

70 % in dementia sample n = 154

Cipher 2004⁴

234

Persistent pain 72 %

Dysfunctional behaviours mean 4.4 (SD 0.76)

r = 0.22 (p < 0.05) with dysfunctional behaviours

7.5

Cipher 2006⁴¹

277

Acute pain 29 %

-

r = 0.18 (p < 0.05) with GLDS mean behavioural intensity

7.5

Chronic pain 59 %

Norton 2010⁴²

161

Not reported

BEHAVE-AD mean 61.4 (SD 29.2)

r = 0.18 (p = 0.03) for pain intensity and disruptive behaviour problems

9

RMBPC-NH mean 1.45 (SD 0.64)

r = 0.05 (p = 0.53) for pain intensity and global need driven behaviours

Tosato 2012³

2822

Any pain 19 % (moderate/severe/excruciating pain 13 %)

Behavioural symptoms 37 %

AOR = 1.4 (95 % CI: 1.04-1.8) with socially inappropriate behaviour

11.5

Psychiatric symptoms 21 %

(Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition)

Williams 2005³⁹

331

Pain 21 %, in nh 23 %, in rc/al 20 % (self-report for subgroup mmse > 10 was higher: 39 % and 25 %)

Behavioural symptoms 58 %

OR = 1.1 (95 % CI: 0.49-2.29) and AOR = 1.2 (95 % CI: 0.57-2.36) with behavioural symptoms

10

(Adjusted for: sex, race, age, cognitive status, number of 10 comorbidities, impairments of 7 activities of daily living)